Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $696.90 / $816.01 / $1,046.83	Facility		$696.90	$816.01	$1,046.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $816.01 / $971.44 / $1,530.01	Professional		$816.01	$971.44	$1,530.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,014.00 / $8,584.00 / $11,253.00	Facility		$4,014.00	$8,584.00	$11,253.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $670.37 / $788.68 / $1,311.11	Professional		$670.37	$788.68	$1,311.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $970.69 / $1,332.32 / $1,536.93	Facility		$970.69	$1,332.32	$1,536.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $951.66 / $1,332.32 / $1,903.32	Professional		$951.66	$1,332.32	$1,903.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,167.94 / $1,167.94 / $1,167.94	Facility		$1,167.94	$1,167.94	$1,167.94
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $116.13 / $116.13 / $116.13	Facility	AS	$116.13	$116.13	$116.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $878.15 / $1,159.47 / $1,938.99	Professional		$878.15	$1,159.47	$1,938.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $973.00 / $4,639.00 / $12,296.00	Facility		$973.00	$4,639.00	$12,296.00
United Facility/Professional Professional Modifier Low / Median / High Price $852.43 / $1,211.03 / $1,915.52	Professional		$852.43	$1,211.03	$1,915.52